Oxygen. By Carol Cassella, M.D., New York, Simon & Schuster, 2008. Pages: 288. Price: $15.00.

The great doctor and the great writer are equally defined by the same faculty: the sympathetic imagination. Without this, the doctor cannot inspire the confidence of the patient, so essential to a successful diagnosis and treatment. Similarly, the unsympathetic author will never succeed in creating well-rounded and believable characters, or forging the necessary connection with her readers. It is this imagination that creates and saves the lives that we cherish the most. Fortunately for us, Carol Cassella’s sympathetic imagination shines through her writing, and its product is her immensely successful first novel: Oxygen .

This book brings readers into the world of Dr. Marie Heaton, who, like the author in real life, is an anesthesiologist. Her routine is launched into chaos after a young girl dies on her operating table from unknown complications. From this moment on, the narrative follows the arc of a Kafkaesque nightmare as one horrific and unresolvable event propels another. On top of her personal turmoil, Dr. Heaton is soon faced with a malpractice suit that becomes more and more serious as the facts of the case begin to reveal themselves. Yet there is more: a vein of intimate troubles runs through the novel as she must deal with an estranged and aging father, an old love returned, the feeling of anonymity engendered by her profession, and the debilitating loss of confidence that follows the death of a child at her hands.

The course of events in Oxygen  is certainly not unheard of in the medical world; many physicians can attest to the shock and personal struggle of malpractice suits from personal experiences. Doctors are often vilified in the mass media—and, therefore, in the public consciousness—as cash-hungry businessmen whose greed leads to disastrous neglect. Oxygen , however, paints a very different portrait of the accused: a confused and guilt-ridden individual who is, above all, a human being—and a highly moral one at that. Yet Cassella’s book is far from a self-congratulatory glorification of the medical profession. Instead, she takes aim at the bureaucracy of the healthcare and malpractice systems, both of which attempt to remove the humanity from dire situations that are all too human.

Yet Oxygen  is not only directed at those who harbor hesitations toward the medical community. Perhaps the best possible reader of this novel would in fact be a fellow anesthesiologist. There is great humor in Cassella’s characterization of various doctors, each of whom conform to knowable “types” (the smugly self-assured surgeon, the thrill seeker, the naively overconfident resident) without settling into clichés. But much more important is the sense of community engendered by this novel. At the core of the work is the search for redemption: how, or even if, the self can again be secured after the terrible accidents that invariably occur in the medical world. As Oxygen  attests, a malpractice suit is an alienating thing, for one must fear not only the loss of faith in oneself, but also the loss of faith of one’s colleagues, friends, and family. While neither unrealistically optimistic nor sadistically dark, Cassella’s brilliant novel provides a voice of comfort for those who have been or will be involved in a malpractice suit at some point in their lives. Oxygen  may not have all the answers, but it does let us know that, despite all appearances, we are not alone.

Brooklyn, New York. david.eisenach@mail.mcgill.ca